Been offered a job at a hospital switching from team nursing to primary nursing...

Daytonite, BSN, RN · Nov 18, 2005

Well, team nursing has taken on a bit of a different definition since I graduated 30 years ago. Basically, it means that you have a team of nursing personnel that divvy up the tasks and patient care that need to be done among them. Nowadays that has evolved into splitting up the team leaders assigned patients among herself/himself and any LPNs or CNAs on their team. The licensed nurses usually give the medications and IVs to their patients. The RN assumes overall responsiblity for making sure that all the care gets done for the patients on her team. This makes you a kind of manager. There are some tasks that only an RN can perform so to account for this use of her time, the team leader often takes a lighter assignment. In my day, we split our teams differently. We put a nurse on meds for all the patients in the team. Our CNAs, if we had them, were assigned easier patients to do basic nursing care on while the LPNs were given the bed patients and those patients who needed dressing changes or other treatments that they could do. The team leader made rounds with the doctors, called the doctors for orders and signed off orders from the charts and made sure the new orders were communicated to the other members of her team. Some places call this person a charge nurse.

Primary care is where you, the RN, are assigned a group of patients, perhaps 4 to 8 and are expected to do everything for them: meds, IVs, baths, turning, ambulating--everything.

HelloKittyRN · Nov 20, 2005

I work in a hospital that is primary care and we don't have to do baths, turns, and ambulation! We are responsible for 4-5 patients and we do an assessment on them and pass meds. We have very good CNA's that do the baths and turns. Most of the time I will help them with the turns and if I have time I will pitch in and help with a bath here and there, but I have never had to do all those things for my whole team. That is why we have such great CNA's that work on floor. Good luck, I think you will like this way of nursing. I enjoy it.

Audreyfay · Nov 20, 2005

I totally enjoyed primary care. It is possible to know your patient more and provide better overall care.

Larry77, RN · Nov 20, 2005

Yikes I always groan when I get assigned primary...I so miss my CNA's to do my post-op vitals HS care and toileting. It's hard for me to stop passing meds or get off the phone with the pharmacy or doc to help one of my patients to the bathroom etc.

It's not that I think I'm above the CNA duties, I was one for ten years, it's just that my RN duties seem to be more important...hmm Or maybe it just messes with my routine...not sure.

At the hospital I work in there is very few LPN's and they only work float on NOC shift so our team nursing is one RN and one CNA for anywhere from 5-7 patients or 4 patients for one RN doing primary care.